Provider Demographics
NPI:1023248812
Name:KING, CHIALIN (LIC AC)
Entity type:Individual
Prefix:
First Name:CHIALIN
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GREAT RD
Mailing Address - Street 2:UNIT 201
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2711
Mailing Address - Country:US
Mailing Address - Phone:781-816-1717
Mailing Address - Fax:781-240-0312
Practice Address - Street 1:200 GREAT RD
Practice Address - Street 2:UNIT 201
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2711
Practice Address - Country:US
Practice Address - Phone:781-816-1717
Practice Address - Fax:781-240-0312
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234421171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist